The results are in for Bradley's 2015 Healthy Hand Washing Survey, which this January queried 1,030 American adults online about their hand washing habits in public washooms as well as their concerns about germs, colds and the flu. Participants were from around the country, ranged in age from 18 - 65+, and were fairly evenly split between men (47%) and women (53%).

More than a quarter of Americans (28%) are more concerned about getting sick with the flu than they were one year ago. Their top two concerns regarding this are that new strains that aren't covered by the flu vaccine and that strains that are mutating or becoming stronger.

Most Americans believe they know how to protect themselves from flu, with 96% agreeing that hand washing is the best way to remove germs and avoid spreading them, 87% knowing that sneezing into the crook of their elbow reduces the risk of sharing an illness and 61% washing their hands more frequently, more thoroughly or longer in response to flu outbreaks.

"Influenza is an unpredictable virus and this year the flu has been particularly widespread, partly because this year's vaccine is not a great match with the current circulating strains of virus," says Dr Nasia Safdar - medical director of infection control at UW Hospital and Clinics.

"The virus is transmitted by contact and by droplets from sneezing and coughing. Thus, hand hygiene and respiratory etiquette are essential for prevention."

Despite the fact that Americans recognise the best ways to shield themselves from cold and flu germs, some popular myths still exist. For example, 71% of the country erroneously think that taking vitamin C protects against colds, hand washing with hot water is more effective (63%) and dressing in warm clothes protects one from a cold (42%).

Even though vitamin C has been touted for the common cold since the 1970s, experts say there's very little scientific proof it has any effect. In terms of hand washing, the temperature of the water makes no difference. Instead, the keys are lathering up thoroughly and scrubbing vigorously for at least 20 seconds as recommended by the Centres for Disease Control & Prevention. However, according to the survey, nearly 60% of Americans wash their hands for just 15 seconds or less, which is not nearly long enough. Finally, there's no evidence that bundling up wards off colds.

The Healthy Hand Washing Survey also found that 70% of Americans take some practical steps to avoid getting or spreading germs but, in general, don't obsess about it. Thankfully, 73% say they stay home when they're sick. And, although surgical masks are common in other countries, just 3% of Americans say they'd wear a mask as a way of deterring germs.

However, when using public washrooms, Americans do feel the need to employ a variety of germ avoidance strategies. Just over half - 57% - operate the toilet flusher with their foot, 55% use a paper towel to avoid touching the door handle directly and 45% use their hip to open and close doors.

In the workplace, Americans take definitive steps to reduce their contact with a sick colleague's germs. Some 62% say they avoid being near the ill co-worker, 56% wash their hands more frequently, 55% stand further away when talking to the colleague and 53% avoid shaking the person's hand. Interestingly, 32% say they'll tell the sick colleague to go home and 3% will stay home from work - even though they're not the one who is sick.

The survey also looked at hand washing habits in public washrooms. It found that 92% of Americans believe it's important to wash their hands after using a public washroom yet 66% admit they've on occasion skipped the soap and simply rinsed with water.

Women in general seem to take hand washing more seriously. They're less likely to skip hand washing after using a public washroom and they're less likely to say they frequently see someone leave a public washroom without washing their hands.

Unfortunately, nearly 60% of Americans say they've had a particularly unpleasant experience in a public washroom due to the condition of the facilities. The top complaints are: a really bad smell (80% of respondents cited odours); toilets that are clogged or not flushed (78% have encountered toilet troubles); and an overall appearance that's dirty, unkempt or old (72% noted this).

For businesses an unpleasant washroom experience creates negative perceptions. A majority of consumers believe a bad washroom indicates poor management, lowers their opinion of the company and shows the business doesn't care about customers.